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CMS on Flooding Emergency Admissions to SNFs click here to view the full documentation Disaster Public Health Emergencies Memo: June 16, 2008 click here to view the full documentation Emergency Shelter of Residents A nursing home will get paid for housing a person who needs shelter due to the flood. First, DHS will implement the 1% provider increase on July 1, 2008 and cover that with 100% of state dollars and then request the normal federal share from the effective date of the change. Federal approval of the 1% is all but certain for those providers for whom state State Plan Amendment approval is necessary. Second, in the event any Nursing Facilities or ICF/MRs have to temporarily transfer patients to another facility because of flooding DHS will make a payment to the transferring facility for the days of care that could not otherwise be billed -- because these facilities will staff have staff and other costs during these periods. DHS will also pay the receiving facilities which are providing the care. DHS will make the payment to impacted facilities and request federal approval for this payment. The Cedar Rapids hospital has also been affected by the flooding. Under current rules it will be paid for the time it handled the patient even though DHS uses a DRG (episode of care) payment methodology. In these cases the fee is split. The Iowa Department of Inspections and Appeals also clarified if a nursing facility was presented with the opportunity to accept relocated residents, they needed to clearly ask:
If is for admission purpose, must handle like any admission and all the processes must be followed. If it is for temporary shelter, for Medicaid DHS was keeping as simple as possible, and must complete the one-page form case activity report for tracking and payment purposes. If there are any questions, should contact DHS. For a Medicare patient/resident the nursing facility must DOCUMENT, DOCUMENT, DOCUMENT that the facility was contacted at ____ time regarding (patient name) _____ due to flooding/disaster, etc and that the facility would be sheltering the resident for an unspecified amount of time…when the resident was received, all services performed, etc. The nursing facility must document everything they do so CMS can sort out the payment pursuant to the documentation. If you have any questions please contact Kristie Oliver at the IAHSA office at 515.440.4630 or 888.440.4630, ext. 104. Processing Medical Facility Transfers due to Emergency Evacuation IM workers should process these transfers as follows: Temporary Emergency Transfers: Emergency Transfers are considered temporary if the intent of the transfer is to provide temporary shelter. These temporary transfers to and from facilities (including all IABC entries) should be handled by the IM worker currently processing the case, --even if the transfer results in a temporary stay in another county. The case record should be retained in the office of the IM worker currently processing the case, and any Case Activity Reports received by another county should be forwarded to the resident's current IM worker. Long Term Emergency Transfers: Emergency Transfers are considered long term if the intent of the transfer is for the resident to remain in the new facility indefinitely. These long term transfers to and from facilities should be handled according to current local office/service area policy for all facility transfers. Iowa Medicaid is currently looking into the process to make additional payments, similar to "bed-hold" payments, to the facilities that had to temporarily evacuate residents. We are aware that those days of care could not be otherwise billed to Medicaid, yet we recognize that the evacuating facilities still have staff and other costs during the periods when residents have been evacuated. We will share the details regarding how these expenses will be allowed/paid as soon as the process is determined. DHS are hoping that facilities will note on the Case Activity Report if the transfer is intended to provide emergency temporary shelter. This will help our staff identify the cases that will need the specific attention for processing. Survey and Certification Issues Related to Iowa and Indiana Flooding Disasters click here to view the full documentation Waivers and/or Modifications
To notify the Department of the need for a waiver or modification of any of the above or for information about the process, contact Mary Spracklin at (515) 281-8632 or (515) 669-6027 (cell), or by e-mail at Mary.Spracklin@dia.iowa.gov. Culver Streamlines State Disaster Grant Program The order suspends a requirement that applicants must provide receipts for disaster-related expenses before getting a state grant. Thus, applicants will be able to use the grant to make repairs rather than spending their own money first and then getting reimbursed. |
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